Vaccine accessibility ought to be a human right. But in the world we inhabit, it operates more as a privilege. Many countries lack the infrastructure to manufacture their own vaccines, and many of these countries are located within the African subcontinent. 

Despite accounting for 20% of the world’s population, Africa’s vaccine industry provides under 1% of global supply.

The continent is almost entirely dependent on vaccine imports, importing over 99%, leaving nations vulnerable to outbreaks and reliant on outside help.

The danger of this dependency was especially evident during the COVID-19 pandemic, which highlighted Africa’s critical gap in vaccine manufacturing, health technologies and sourcing for vital drugs and vaccines.

Despite the secure increase in global vaccine production during the pandemic, with 1.5 billion doses produced per month, Africa experienced an acute vaccine supply shortage. 

Core to any effective disease response is coordination and speed.

Local authorities and healthcare providers cannot act quickly to protect people’s health when reliant on offshore manufacturing, having to navigate supply chains, shipping and distribution processes during intense global disruption.

In 2022, when more than 9 billion vaccine doses had been produced, Africa had only received 540 million. This is 6% of all COVID-19 vaccines, a staggering statistic when you consider that 17% of the world’s population lives on the continent.

The process to vaccinate people across Africa was significantly slower than in Europe and the US, with many Africans only receiving their first vaccination in 2023. This in turn led to a greater spread of infection and preventable deaths.

Africa stands to benefit significantly from the sustainable growth of its vaccine manufacturing sector.

Not only will this growth enhance healthcare access and save lives, it will also economically benefit African nations.

Vaccine demand across the continent is valued at over US$ 1bn annually, with this figure projected to increase over the coming decades in alignment with population growth. 

With all these benefits, one critical question remains: Why hasn’t Africa developed independent vaccine manufacturing capabilities yet? 

Why Isn't Africa Already Manufacturing It's Own Vaccines?  

The economic challenge of establishing Africa in the vaccine market 

An agreement was signed in March 2022 by leading biotechnology manufacturer Moderna, to build a US$500m manufacturing mRNA plant in Kenya. 

These mRNA vaccines work by training the immune system to spot and destroy certain pathogenic threads by delivering genetic coding to the body. These vaccines can be more rapidly tailored to different diseases, or variants of the same disease, making them desirable to confront mutating disease strains. 

Biotechnology experts believe mRNA vaccines will be regarded as superior within the following decade, capable of treating HIV, seasonal influenza and rabies among other diseases.

Diseases which disproportionately affect Africa and account for a significant number of global cases.

The plan was for the Moderna plant to annually produce 500 million doses of crucial vaccines. However, Moderna pulled out of the agreement. 

Why? Because not a single African country had ordered its COVID-19 vaccine since 2022, leaving the company with US1$bn in losses and write-offs.

The affordability of the new plant was put into doubt, a doubt which ultimately ended the agreement. 

This lack of orders can be explained by Africa’s reliance on other countries like India, known as the “pharmacy of the world” which provides affordable mass manufactured vaccines.

The extent of this reliance is evident in the South African government's decision earlier this May to order vaccinations from Indian company Cipla despite hosting its own mRNA hub, Biovac. 

According to officials, they opted to order the vaccines rather than manufacture them because doing so would save the Health department enough money to introduce two new childhood vaccines.

Shaping the lack of independent vaccine manufacturing in Africa is a notable tension between local production capacity and price pressures.

There are African vaccine manufacturers who have the robust financial capabilities needed to finance facilities and manufacture vaccines.

But what they lack is a strategic business case to produce those vaccines, ergo strong commercial capabilities.

As of now there is no driving financial incentive for manufacturers and healthcare providers to invest in creating vaccines rather than ordering them.

The time it takes to manufacture vaccines heightens this. In South Africa, the MRNA vaccine technology transfer hub has trained scientists from 15 countries, including six in Africa to produce mRNA vaccines themselves.

Within a year of the hub’s launch, Afrigen developed an mRNA COVID-19 vaccination, but by that point, the market had stalled, prompting the manufacturer to alter its focus. Today Afrigen is working to develop mRNA vaccines for HIV and tuberculosis.

With the extensive time it may take for such vaccines to hit the market, the hub unfortunately faces the same problem as Moderna- economic uncertainty.

All of these factors come together to make it challenging for local African manufacturers to establish themselves in the vaccine market.

There is a strong economic incentive to continue ordering vaccines from abroad, one which benefits countries in the short term, but ultimately enhances their vulnerabilities in the long term. 

Scientific brain drain 

‘Brain drain’ describes the emigration of highly qualified people from countries. There are a lot of factors which can trigger ‘brain drain’ like oppressive political regimes, lack of economic opportunity and the promise of higher wages and living standards abroad. 

In 2020 the UN reported that migration from Africa increased by 30% since 2010.

The majority of that is intra-African migration. But critically, individuals classed as highly educated and/or skilled were likelier to be moving to the UK, the US, Canada or France

This is especially true for those with STEM talents, who seek employment reliability and higher wages abroad in large numbers, leading to a specifically ‘scientific’ variant of brain drain.

For example, according to UK Home Office data, Nigeria, Zimbabwe and Ghana all made the top ten list for work visas granted in 2023, migrating to the UK to fill critical employment roles.

Thousands of NHS openings have been filled by African professionals, with new NHS nurses from Ghana rising by 1,328% between 2019 and 2022.

Today more Ghanaian nurses work in the UK than in Ghana, with nurses and doctors from Kenya and Botswana also represented highly among NHS staff.

This migration is having a detrimental impact on health staffing across Africa.

A report last year from the World Health Organisation found that roughly 80% of the African continent, which accounts for forty countries, is facing significant shortages of healthcare staff. WHO reports that 500 nurses leave Ghana for the West every month. 

Independent vaccine manufacturing cannot progress without a robust healthcare system and experienced, educated professionals to lead the process.

Tackling the brain drain facing Africa is a complex challenge that will require leaders and communities to invest in local infrastructure and economic opportunities whilst challenging prevailing mindsets.

A gap in technologies, tools and training

The partners of the Biovac hub in South Africa are enduring even steeper challenges. These partners, based in Senegal, Nigeria and Kenya lack manufacturing infrastructure, with pharmaceutical sectors in their infancy.

With difficulties importing equipment and a limited scientific workforce driven by ongoing brain drain, there’s a systemic issue with training and tools.

An example of this is the heavy concentration on form/fill/finish in African vaccine manufacturing.

This process refers to the end stage of manufacturing where vials/ syringes are filled with finished vaccines, undergo quality inspection and are then labelled and packaged. African manufacturers are reliant on technology transfers from vaccine manufacturers abroad to support this, but they currently face insufficient transfers to support current and future plans in this area. 

These plans in and of themselves pose a challenge, as adding significant additional form/fill/finish capacity creates a risk that this will overstep demand. Resulting in manufacturing projects that are unsustainable and not commercially viable.

Analysis from The African Center for Disease Control and Prevention (CDC)  also found that only a few African companies have the technology to produce antigens. Antigens, which trigger immune responses, are a critical component of any effective vaccine.

The capacity to produce antigens locally is significantly below the capacity required to meet regional production targets.

Without addressing this gap in technologies, tools and training, independent vaccine manufacturing across Africa will not be commercially and economically viable. 

The impact of colonialism 

It is of course no coincidence that African countries are partly reliant on the vaccine manufacturing capacity of nations like France, the UK and Germany. Today, the wealth and stability of these nations- which is built on the foundation of African colonisation- attracts migration fuelling brain drain across Africa. 

Most of Africa spent at least two generations under formal colonial rule. This history and the way it’s shaped political and economic development within Africa cannot be dismissed. 

European colonialism induced large inflows of investment, facilitating railway construction and profoundly shaping the operation of land and labour markets. 

This process tied technological introductions to oppressive systems and blocked independent economic and political development. Politically, colonialism made local elites less accountable to their citizens, creating a system that rewarded corrupt rulers who facilitated the needs and demands of outside actors. 

Economically, colonialism has contributed to a lack of independent economic infrastructure across the continent. Foreign aid, particularly in the form of mass-manufactured goods, weakens this infrastructure and sovereignty further. Africa also faces certain geographical realities- like an uneven distribution of resources and several landlocked countries- that contribute further to high poverty rates. 

Africa must break free from unequal relationships with other countries and invest in robust, independent infrastructure and local opportunities. Vaccine manufacturing is a critical place to start, a fact recognised by Gavi and the Africa CDC.

Read on to part two to discover how they're tackling this challenge.

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